Wednesday, December 31, 2008

Biography: James Jackson Putnam (Oct.3 1846-Nov. 4, 1918)

A neurologist, he was born in Boston, Mass., the son of Charles Gideon, a physician, and Elizabeth Cabot (Jackson) Putnam. He was a brother of physician Charles Pickering Putnam. He graduated from Harvard College in 1866 and Harvard Medical School in 1870. After completing an internship at the Massachusettes General Hospital he studied neurology in Leipzig, Vienna, and London, where he was influenced by Carl Rokitansky, Theodor Meynert and especially by John Hughlings Jackson.

Putnam was one of the pioneers of neurology in the United States. After returning from his European studies in 1872, he started one of the first neurological clinics in this country, at the Massachusettes General Hospital. Because of a lack of hospital facilities at that time he established a neuropathological laboratory in his own home. In 1874 the Harvard Medical School appointed him Lecturer on the Application of Electricity in Nervous Diseases, a title which reflects the infant status of the field of neurology at the time. In the same year Putnam was one of the seven charter members of the American Neurological Association, and he served as its president in 1888. He was also a founder of the Boston Society of Psychiatry and Neurology. By 1893 he had risen to the rank of Professor of Diseases of the Nervous System at Harvard--a position which he held until 1912, when he was made Professor Emeritus.During a career that spanned nearly 50 years he published over one hundred papers on clinical and pathological neurology. Early in his career he did experiments on localization of brain functions with Henry P. Bowditch, a professor of physiology at Harvard. Most of his neurologic work focused on disorders of the spinal cord and peripheral nerves. His first significant publication, in 1881, was the earliest adequate discription of parasthesias in the hands. He wrote important papers on neuritis, particularly neuritis due to lead and arsenic poinoning. He also spoke out on social issues, notably, in 1879, defending the place of women in medicine.

While he was severely critical of functional or psychological explanations of nervous symptoms during the first decade of his career, his views changed radically over the years. This change in attitude appears to have been influenced by his extensive experience giving medico-legal evidence in in cases of traumatic neuroses. Between 1890 and 1909 Putnam cooperated informally with psychologists, philosophers and psychiatrists, including William James, Josiah Royce and Hugo Munsterberg, to develop a sophisticated, scientific psychotherapy. The first published evidence of Putnam's changing views was an 1895 paper titled "Remarks on the Psychical Treatment of Neurasthenia." In 1906 Putnam published the first clinical test of psychoanalysis in an English-speaking country, concluding that Freud's claims were stimulating but exaggerated.

While some physicians like Putnam "flirted" with psychotherapeutic techniques around the turn of the century, psychotherapy didn’t explode into the American consciousness until 1906 with the Emmanuel Movement. The Emmanuel Movement, a church-based initiative in the progressive spirit of the social gospel and supported by leaders of the Boston medical community, promised to treat (free of charge) psychoneurotic patients. The ministers at Emmanuel Church were so successful in their treatments, and demand across the country was so great, that physicians feared they had committed professional suicide. They turned-coat and, with much effort, effectively ended the movement. Putnam was among most visible and vocal of the physicians both in his initial support for the movement and in his later repudiation of it.

In recent years Putnam's pioneering work in establishing neurology as a medical specialty in the United States has been overshadowed by interest in his role in establishing the psychoanalytic movement in this country. His serious involvement in psychoanalysis began during Freud's visit to Clark University in 1909, where the two men had a chance to talk at length. In the last decade of his life Putnam wrote over thirty papers on psychoanalysis and related topics. Putnam's stature among neurologists secured a hearing for Freud's views within the profession and his reputation for sound scientific judgement and unimpeachable integrity played a crucial role in the American acceptance of psychoanalysis.